Summary. A prospective cohort study was carried out to determine
the prevalence of tooth wear in the permanent dentition of a sample of
12 year-old school children and to establish whether an association
exists between tooth wear recorded now, and tooth wear recorded in their
primary dentition at age five. At follow-up to a previous study,
complete data were available for 123 children; fieldwork was conducted
in the child's primary school. Measurement of tooth wear used a
scoring system modified from the Smith and Knight Tooth Wear Index
(TWI). Tooth wear which had progressed to dentine was assessed on the
occlusal surfaces of the 4 first permanent molars, the labial,
lingual/palatal and incisal surfaces of the 6 upper and 6 lower anterior
teeth; a total of 40 scoreable surfaces. Demographic data were collected
from the parents, and a questionnaire on oral hygiene habits, diet and
behaviours completed by each child. In total 38% (n = 47) of subjects
had tooth wear, if incisor teeth only were included, 33% (n = 40) had
tooth wear and similarly if the occlusal surfaces of molar teeth only
were included 10% (n = 12) had signs of tooth wear. Gender was
significantly associated with tooth wear: males had more tooth wear. The
presence of tooth wear with dentine exposed in the primary dentition was
significantly associated with tooth wear on the occlusal surfaces of the
first permanent molars. Males had more tooth wear than females. An
association existed between tooth wear recorded at age 5 and molar tooth
wear recorded at age 12. Tooth wear is a lifelong cumulative process and
should be recorded in both the primary and permanent dentitions.

Comment. When advocating the prevention and treatment of dental
caries in the primary dentition, it was, and still can be, met with the
opposing view that it's 'only baby teeth and they'll fall
out'. An obvious defence, amongst many others, is that to ignore
disease in the primary dentition is simply laying the foundations of
disease progression to the secondary dentition. This paper enlightens
with its well-constructed execution and delivery and provides further
evidence that diseases, such as erosion, in the primary dentition serve
as timeous indicators of potential disease in the succedaneous dentition
and at a time whereby prevention can be key to avoiding further disease.